Terms of Employment:
• W2, Contract
• 3 Months with possible extension
• Predominantly remote. There will be occasional onsite visits to our client’s office in either: Canton, MD, Washington D.C., Owings Mills, MD or Columbia, MD. Candidates must reside within the Maryland, DC, Virginia or Delaware area.
Overview & Responsibilities
Join our client’s Special Investigations Unit (SIU) as a Medical Coder, leveraging your medical coding expertise to combat fraud, waste, and abuse in healthcare claims. This vital role involves the prepayment review of medical records to ensure accurate billing per industry standards and internal policies. You will be instrumental in clearing a significant backlog of claims and contributing to the integrity of the claims process. This is an excellent opportunity for a certified medical coder seeking a high-impact role with potential for long-term employment. Key responsibilities include:
• Review medical records and claims for fraudulent indicators and coding accuracy.
• Determine if claims are accurately billed per industry standards (e.g., AMA guidance, AAPC guidance) and internal payment/medical policies.
• Render determinations on claims, which may include denying or paying them based on review findings.
• Utilize coding software (e.g., Codify, Optum Encoder Pro) or CPT manuals to aid in code review and ensure all required components of office visits are met.
• Manage a high volume of claim reviews, contributing to the reduction of a significant backlog.
Required Qualifications:
• High School Diploma or GED.
• Active and validated Certified Professional Coder (CPC) certification or equivalent accreditation (e.g., CPMA, COC, or AHIMA accreditation) without Apprentice tag.
• 3 years of experience in risk adjustment coding, ambulatory coding, and/or CRC coding experience in managed care, state or federal healthcare programs, or the health insurance industry.
• Experience in physician coding, specifically reviewing office visits and services rendered in a physician's office.
• Proficiency in reviewing medical records and claims for coding accuracy.
• Detail oriented.
Preferred Qualifications:
• Experience using coding software such as Codify (AAPC) or Optum Encoder Pro.
...insurance * Health insurance * Life insurance * Paid time off * Vision insurance Medical Specialty: * Genetics & Genomics * Hospice & Palliative Medicine * Pain Medicine Physical Setting: * Long term care * Nursing home * Rehabilitation center...
...Inpatient call responsibilities Management of eye lid lacerations and foreign bodies required Paid malpractice insurance; pre-paid travel and housing expenses Assignment details and time entry in online portal Competitive compensation 24-hour access to your Weatherby Healthcare...
...have the support of a dedicated, local management team and the training needed to perform your job safely, and with care. Bus drivers are... ...verifiable driving history Ability and willingness to obtain a CDL Complete a comprehensive CDL training program Pre-...
...it shine. At this time, STAR has an open position for an IT Support Specialist (full-time, non-exempt). This position plays a critical... ...tasks and timelines. Qualifications: Systems and software proficiency including but not limited to: Basic Networking understanding...
Research Coordinator For Scholarship Of Teaching And Learning Mass General Brigham relies on a wide... ...majority of the work can be conducted remotely, though in-person work may be required... ...and AbilitiesWorking knowledge of clinical research protocolsCareful attention to...